Nasal cavity and paranasal sinuses

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Author: Mikael Häggström [note 1]

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Nasal or sinonasal polyps

Look for signs of malignancy. Further information: Evaluation of suspected malignancies

Benign nasal/sinonasal polyp (not otherwise specified), consisting of hyperplastic edematous connective tissue with some seromucous glands and inflammation (mostly neutrophils and eosinophils), surrounded by respiratory or squamous epithelium.[1] It can be termed inflammatory nasal/sinonasal polyp when inflammation is more pronounced.

Main differential diagnoses:

  • Inverted papilloma, wherein the surface epithelial cells grow downward into the underlying supportive tissue.
    Inverted papilloma, wherein the surface epithelial cells grow downward into the underlying supportive tissue.
  • Squamous papilloma, with acanthosis and hyperkerratosis.
    Squamous papilloma, with acanthosis and hyperkerratosis.

In case of significant inflammation:

  • Take at least one high magnification look to confirm that it is mixed and that lymphocytes are not atypical (otherwise, consult hematopathology, particularly whether it could be a lymphoma, notably extranodal NK/T cell lymphoma, nasal type.
  • (Classify as acute (with neutrophils) versus chronic (lymphocytes, eosinophils and/or plasma cells). Also look at any bone fragments for osteomyelitis.) Further information: Osteomyelitis
  • Benign chronic mixed inflammation of an inflammatory sinonasal polyp.
    Benign chronic mixed inflammation of an inflammatory sinonasal polyp.
  • Acute inflammation characterized by neutrophils.
    Acute inflammation characterized by neutrophils.
  • Extranodal NK/T cell lymphoma, nasal type.[2] These lymphoma cells are typically monotonous, with folded nuclei, indistinct nucleoli and moderate amount of cytoplasm.[3]
    Extranodal NK/T cell lymphoma, nasal type.[2] These lymphoma cells are typically monotonous, with folded nuclei, indistinct nucleoli and moderate amount of cytoplasm.[3]

Reporting

Example:

Right and left sinus contents, excisions:
Benign respiratory mucosa with chronic inflammation.
Bone without significant histopathologic changes.

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ Michaels, Leslie (2012-12-06) (in en). Ear, Nose and Throat Histopathology . Springer Science & Business Media. p. 168. ISBN 9781447133322. 
  2. ↑ Takahara M, Kumai T, Kishibe K, Nagato T, Harabuchi Y (2021). "Extranodal NK/T-Cell Lymphoma, Nasal Type: Genetic, Biologic, and Clinical Aspects with a Central Focus on Epstein-Barr Virus Relation. ". Microorganisms 9 (7). doi:10.3390/microorganisms9071381. PMID 34202088. PMC: 8304202. Archived from the original. . 
    - "This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)."
  3. ↑ Mario L. Marques-Piubelli, M.D., Carlos A. Torres-Cabala, M.D., Roberto N. Miranda, M.D.. Extranodal NK / T cell lymphoma, nasal type. Pathology Outlines. Last author update: 5 January 2021. Last staff update: 14 October 2021

Image sources


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